Ligament Laxity
Ligament Laxity is when the ligament is too loose and will not hold the joint in proper alignment when it moves. This condition can be called a joint hypermobility syndrome due to an underlying medical condition, in which case all the ligaments in the body are affected and all the joints are affected.
What we’re talking about when we talk about spinal ligament laxity, is ligament laxity that is traumatically induced. The spine is comprised of 34 vertebrate and over 100 intricate joints are all held together with more than 220 specialized ligaments. 23 of those ligaments happen to be discs. The spinal ligaments job is to hold the spinal bones in optimal alignment throughout all of the complex movement patterns, which occur with all of our daily activities.
These ligaments allow all of these complex movement patterns to occur without allowing the spine to go out of alignment and interrupting or interfering with either the intricate network of blood vessels that are involved or the intricate network of spinal nerves that are involved.
When a spinal nerve is involved, it can cause either a motor dysfunction, which is a weakness in muscle function, it can cause sensory problems which are improper sensations like numbness and tingling in the arms and legs or sciatica, or it can cause pain.
Ligaments, like plastic, resist deformation but when they’re overwhelmed with force, they will deform, usually by hyperstretching and/or they could even completely break. The most common form, when we say ligament laxity though, we mean the ligament has not broken it’s just deformed. And once it’s deformed, that deformation is permanent and that deformation now allows the vertebrae to go out of abnormal positions and interfere with the nerve. When this condition occurs, clinically we say it’s now a spinal instability.
Spinal instability is when the ligaments are lax enough that they are no able to hold the spine in position and they’re causing either a motor sensory or a pain problem at that level.
As we know, with ligament injuries, there are two serious problems that can occur and there are two imaging biomarkers that pick these problems up using two distinctly different imaging procedures.
One is if we have a disc herniation. That is picked up with an MRI. The other is excessive motion from the ligament laxity itself and that is picked up on X-ray study with Stress X-rays and accurate measurements of the excessive motion to the spinal vertebra themselves. This latter condition of excessive motion, MRI was never designed to pick up and report. These findings, of course, are so important as they drive all factors of spinal care and care reimbursements in the injury market.
Because of that, the significance of the findings and the ability of the findings to drive care plans, the testing for ligament laxity should be performed by unbiased, independent, board certified medical radiologists and should not be done by the treating providing who may be biased and try to skew the results.
Ligament laxity is picked up with spinal kinetics via a very simple testing procedure called a CRMA. CRMA is an advanced X-ray measurement technology that allows spinal kinetics board certified medical radiologist to accurately measure the exact abnormal, intersegmental motion patterns that are associated with ligament laxity.
This allows the doctor to accurately assess this condition and then put the patient through an appropriate treatment plan to minimize the negative effect of this condition.
